Heart Failure

Heart failure affects nearly 5 million Americans. It is a condition in which the heart can’t pump enough blood to meet the body’s needs.
There are 2 scenarios that can happen regarding heart failure:
1) The heart can’t fill with enough blood.
2) The heart doesn't have enough force to pump blood to the rest of the body.
Heart failure does NOT mean that your heart has stopped or is about to stop working, but it is a serious condition that requires medical care. The disease generally affects those aged 65 years and over, yet many people go undiagnosed because the symptoms for heart failure may be mistaken for symptoms of aging.
Below is a picture of a normal heart compared to one with heart failure:


external image heart-failure.jpg

Photo Credit


Heart Failure Information


Statistics
The numbers for heart failure are continually increasing, especially in the population aged 35 years and older. The image below displays these statistics by county:

Heart Failure Death Rates, 2007-2009. Age-adjusted average annual deaths per 100,000 among adults ages 35 and older, by county. Rates range from 58.1 to 720.3 per 100,000. Counties with the highest rates are located primarily in Mississippi, Oklahoma, northeastern Michigan, eastern Kentucky, Northern Alaska, and parts of Alabama and Texas.
Heart Failure Death Rates, 2007-2009. Age-adjusted average annual deaths per 100,000 among adults ages 35 and older, by county. Rates range from 58.1 to 720.3 per 100,000. Counties with the highest rates are located primarily in Mississippi, Oklahoma, northeastern Michigan, eastern Kentucky, Northern Alaska, and parts of Alabama and Texas.

  • Approximately 5.7 million people in the United States have heart failure and an estimated 400,000 to 700,000 new cases are diagnosed annually.
  • Heart failure is the primary cause of more than 55,000 deaths annually.
  • Nearly half of those diagnosed with heart failure will die within 5 years of diagnosis.
  • Heart failure costs the nation $34.4 billion annually. This includes the cost of health care services, medications, and lost productivity.
  • Among adults aged 18-64 years, the cost of hospitalization was higher when heart failure was the secondary diagnosis rather than the primary diagnosis ($25,325 versus $17,654).
Heart Failure Stats


Basics about Heart Failure
Mayo Clinic: Basics of CHF
WebMD Basics of Heart Failure
Quick Facts:
  • You cannot reverse any conditions of heart failure. You instead must control risk factors such as high sodium diets, coronary artery disease, obesity, high blood pressure, high stress, and diabetes.
  • Heart failure is often treated with positive results, medications can improve symptoms and even help you live longer.
  • Swelling legs and ankles occur because the body is retaining salt and water.
  • There are four classes of heart failure, categorized by severity:
    1. Class I: least severe, physical activity is unaffected and symptoms minimal to none.
    2. Class II: mild symptoms during activity but none during rest.
    3. Class III: severity increased significantly such as fatigue, shortness of breath, palpitations, and pain during normal activities.
    4. Class IV: very severe, discomfort occurs continuously and increases with physical activity.

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Here are some additional resources for basic information on Heart Failure:
Animated explanation
What is Heart Failure?
Heart Failure General Info


Stages of Heart Failure
There are four stages of heart failure. Patients are ranked as either class I-II-III-IV, according to the degree of symptoms or functional limits.


classification of heart failure.jpg
The following websites outline the stages along with giving a definition of the stage and the usual treatments:
What are the Types of Heart Failure?
Classifications of Heart Failure
Heart Failure

Causes/Risks
Common causes of Heart Failure include:
  • Coronary artery disease
  • Hypertension
  • Long term alcohol abuse
  • Disorders/complications of the heart valves
  • Congenital heart disease
  • History of Heart Murmurs
  • People who are 65 years or older because aging can weaken the heart
  • Being overweight
  • Already having had a heart attack

Heart Failure Risks
Who is at Risk of Heart Failure

Symptoms of Heart Failure
The most common signs and symptoms of heart failure are:
  • Shortness of breath or trouble breathing
  • Fatigue (tiredness)
  • Swelling in the ankles, feet, legs, abdomen, and veins in the neck
  • Rapid or irregular heartbeat
  • Reduced ability to exercise
  • Persistent cough or wheezing with white or pink blood-tinted phlegm
Signs and Symptoms

Symptoms to Not Be Ignored for Current Heart Failure Patients
Contact your doctor right away if you experience these warning signs:
  • Sudden weight gain (e.g. 3 lbs in a day, 5 lbs
    a week)
  • Shortness of breath unrelated to activity
  • Swelling in the legs or ankles
  • Swelling or pain in abdomen
  • Trouble sleeping
  • Increased fatigue
  • Frequent dry, hacking coughs
  • Fatigue

More Warning Signs
What are the Signs and Symptoms

Prognosis
Heart failure is a chronic disease, which can be more serious in the presence of an additional disease, injury, or physical trauma. Most heart failure occurrences can be managed by medication, life style changes, and treatment of other contributing disease.
Outlook for Heart Failure: New York Times Article

Complications
  • Irregular heart rhythms (can be deadly)
  • Pulmonary edema
  • Headache
  • Light-headedness and fainting
  • Total heart failure (circulatory collapse)
Heart Failure Complications


Treatments of Heart Failure
  • Medication
  • Lifestyle changes
  • Surgical Interventions
Heart Failure-Treatment Overview
How is Heart Failure Treated?
Congestive Heart Failure YouTube Video


Common Medications
  • Diuretic
  • ACE inhibitors
  • Angiotensin II receptor blocker
  • Beta-blocker

These medications are prescribed to reduce blood pressure, the build up of fluids and swelling, as well as the workload of the heart.
Medications - Overview
Diuretics
ACE inhibtiors
Angiotensin II receptor blockers
Beta blockers

General Side Effects of Medications
  • Cough
  • Gastrointestinal upset
  • Low blood pressure
  • Muscle cramps

Over-the-counter medicine can worsen heart failure symptoms. Always consult your doctor or pharmacist before taking medication.
Possible Complications


Prevention

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  • Keep heart rate, blood pressure, and cholesterol under control
  • Avoid tobacco
  • Maintain a healthy diet
  • Consume alcohol in moderation
  • Reduce salt intake
  • Exercise as recommended by your health care provider
  • Keep diabetes under control
  • Do not leave anemia untreated
Q&A for Prevention of Heart Failure


Research Related to Heart Failure
Rapid Measurement of B-Type Natriuretic Peptide
in the Emergency Diagnosis of Heart Failure:

http://www.nejm.org/doi/pdf/10.1056/NEJMoa020233


Preventing Heart Failure and Improving Survival:
http://www.nejm.org/doi/full/10.1056/NEJMe1011742

Cardiac-Resynchronization Therapy for Mild-to Moderate Heart Failure:
http://www.nejm.org/doi/pdf/10.1056/NEJMoa1009540

Cardiac-Resynchronization Therapy for the Prevention of Heart-Failure
http://www.nejm.org/doi/full/10.1056/NEJMoa0906431

Long-Term Use of a Left Ventricular Assist Device for End-Stage Heart Failure:
http://www.nejm.org/doi/pdf/10.1056/NEJMoa012175

Epidemiology of Heart Failure
http://eurheartj.oxfordjournals.org/content/18/2/208.full.pdf

Omega 3 Fatty Acids and Older Adults with Heart Failure
http://www.crnusa.org/benefits/files/15CRN-BenefitsBook-epadha.pdf



Resources/ News about Heart Failure
Minneapolis Heart Institute Valve Center at Abbott Hospital:
Valve abnormalities that cause aortic stenosis and mitral insufficiency predominantly affect our growing elderly population. In the United States, an estimated 140,000 patients suffer severe aortic stenosis annually. When aged in our 80s, 5% to 7% of us will develop severe stenosis. By the time we reach our 90s, 10% to 12% of us will become afflicted with this disease. Mitral insufficiency is even more common.
Currently in the United States, conventional surgical valve repair and replacement are the only treatment options. Elderly patients with comorbidities or excessive frailty are at greater risk for these invasive treatments. Medications have minimal effect on symptoms, and unlike surgery, they don’t change the natural history of the disease. Without invasive treatment options, these patients face a painful decline in quality of life, reduced longevity and heart failure. Continue the story at: http://www.mdnews.com/news/2011_11/05838_oct2011_minneapolis-heart-institute



Other Important Information
Living Well with Heart Failure:
https://www.nhlbi.nih.gov/files/docs/public/heart/living_well.pdf

Heart diseases and cold weather:
http://www.heart.org/HEARTORG/General/Cold-Weather-and-Cardiovascular-Disease_UCM_315615_Article.jsp

Information about Senior Health:
http://nihseniorhealth.gov/heartfailure/toc.html